National & the tobacco industry

Tony Ryall has, once again, taken the moral low road and is refusing to ban cigarette displays in shops despite evidence that cigarette displays increase teenage smoking. This in a week that a similar ban was announced in Northern Ireland, joining bans in Ireland, Canada, England, Wales, much of Australia… oh shall I just call it “most of the developed world”?

Why does this matter? (Other than caring about the lives and health of New Zealanders)

National is, once again, picking the tobacco industry over people’s lives and health

National is, once again, choosing the moral wrong for the employers and owners’ benefit

National is, once again, showing the signs of a party financially entangled with the tobacco industry.

In case you don’t have a copy of The Hollow Men to hand, I offer you some highlights:

Matthew Hooton, long time National mouthpiece, ex-National staffer and National lobbyist has done private pro-tobacco PR work and lobbying. His work was used by Rodney Hide to attempt to stall anti-tobacco legislation.

British American Tobacco’s chief lobbyist is a significant National Party donor and has been invited to caucus parties.

Key’s political advisors, Crosby|Textor, name British American Tobacco as a client of Mark Textor.

Sweet eh, politicians and industry working hand-in-hand – that must be the “pragmatism” John Key talks about.

21 Responses to “National & the tobacco industry”

My thought on hearing the claim that “evidence could not directly link the banning of displays with decreasing smoking rates” this morning was: doesn’t that invalidate the main argument againt the ban, viz. that it will reduce the revenue earned by retailers?

Ryall is technically correct in that the evidence that banning displays reduces smoking rates is very weak. The study you quoted demonstrated a link between youth starting smoking and the number of visits to corner dairies with cigarette displays. It did not demonstrate that removal of the displays reduced smoking. Correlation does not necessarily means causation.

Having said that, I support the removal of these displays if only because it is a logical extension of the banning of tobacco advertisements. It seems odd to ban adverts but allow flagrant displays in every dairy.

At the moment, the National government would be very wary of bans. They have just spent an entire campaign on the horrors of the “Nanny state”. It would be politically dangerous for them to start banning things at this stage. I predict displays will go shortly after the 2011 election, regardless of who gets in.

This is not logical at all. According to a study in Lancet see graph here Alcohol is more harmful than tobacco. In fact Alcohol is more harmful than many drugs that are illegal. To have a consistent drug policy we should either ban alcohol advertising as well or legalise all drugs less harmful than alcohol. Somehow I think we’ll continue with the totally irrational drug policy we already have.

QTR: The lancet graph from the MAP site is totally out of context. You can find the actual lancet article here. You may need to register to read it. I quote the following from the article.

However, direct comparison of the scores for tobacco and alcohol with those of the other drugs is not possible since the fact that they are legal could affect their harms in various ways, especially through easier availability.

Firstly, the harms of a given drug will depend upon its legal status. The best way to demonstrate this point is with heroin, which is placed at the top of the Lancet-scale as the most harmful of all drugs. For street heroin this may well be the appropriate placing, but, if we are being scientific here, it is imperative to separate out the harms that follow from use of the drug per se, and the health and social harms exacerbated or created specifically by the drug’s use within an illegal market. These, lets call them ‘prohibition harms’, include:
Contaminated/cut product (poisoning, infection risks)
Dirty/shared needles (Hep C / HIV risk)
Vast quantities of low level acquisitive property crime to support a habit: illegal markets inflate the cost of an essentially worthless agricultural product to one that is worth more than its weight in gold. People on prescriptions don’t have to nick stuff.
Street prostitution (see above)
Street dealing, drug-gang violence and turf wars
Drug litter (needles in the gutter etc)

One of the authors of the article thinks things need to change:

“The policies we have had for the last 40 years … clearly have not worked in terms of reducing drug use. So I think it does deserve a fresh look. The principal objective of this study was to bring a dispassionate approach to what is a very passionate issue.”

“What we are trying to say is we should review the penalties in the light of the harms and try to have a more proportionate legal response.
“The point we are making is that all drugs are dangerous, even the ones that people know and love and use regularly like alcohol.”

I don’t think anyone with a modicum of sense thinks we have a rational drug policy. The only choice is whehter we continue with a more draconian system (incl banning tobacco advertising) a system that has been a manifest failure or go with a more liberal system.

Anyway the point about Alcohol v Tobacco stands ignoring all other drugs – it would be ridiculous to ban alcohol advertising as it is to ban tobacco advertising.

QTR: What you are not quoting is the method they used to determine this – a series of meeting of addiction experts. Alcohol and tobacco were heavily weighted by their social harm because of their extensive use, due to the fact they are legal. The “prohibition harms” talked about do not offset the massive differential in sheer numbers involved in alcohol and tobacco use.

You can see this illustrated in the original graph you linked to. Alcohol is higher on the scale than tobacco, despite the fact that tobacco is a far more toxic drug at moderate use levels (say compare 2 alcoholic drinks a day to 10 cigarettes). Far more people drink alcohol than smoke. Where alcohol scores points is in the massive social disruption and health consequences of overuse. Almost all the other drugs listed in the lancet study have serious mental or physical side effects at “normal” levels of usage. Alcohol has proven benefits at low levels of use. Something you can’t say for tobacco.

James on March 4th, 2009 at 16:14

Look….just leave consenting adults to consume as they please and others to supply them and advertise….and leave the consequences with them…..don’t collectivise them onto the rest of us

The immoral war against drugs (of all kinds) was only ever a war against freedom, reason and objective reality.

Quoth the Raven on March 4th, 2009 at 16:14

Mac – I realise you pointed it out in your first comment. Nevertheless the article explicitly says:Our methodology offers a systematic framework and process that could be used by national and international regulatory bodies to assess the harm of current and future drugs of abuse.

Your argument may work for social harm, but it doesn’t follow from their critieria which included, as well as social, physical harm, and dependence – two things that are not altered by the relative number of users. For instance Barbituates score high on their criteria despite being hardly used at all nowadays. They’re not so stupid a to throw all proportionality out the window in this study. Further the article points out just before the quote you provided above: Tobacco and alcohol were included because their extensive use has provided reliable data on their risks and harms, providing familiar benchmarks against which the absolute harms of other drugs can be judged.
You ought to have read the discussion, this part for instance: Take tobacco, for instance. Smoking tobacco beyond the age of 30 years reduces life expectancy by an average of up to 10 years,[9] and it is the commonest cause of drug-related deaths, placing a huge burden on health services. However, tobacco’s short-term consequences and social effects are unexceptional.

And most importantly:

Our findings raise questions about the validity of the current Misuse of Drugs Act classification, despite the fact that it is nominally based on an assessment of risk to users and society. The discrepancies between our findings and current classifications are especially striking in relation to psychedelic-type drugs. Our results also emphasise that the exclusion of alcohol and tobacco from the Misuse of Drugs Act is, from a scientific perspective, arbitrary. We saw no clear distinction between socially acceptable and illicit substances. The fact that the two most widely used legal drugs lie in the upper half of the ranking of harm is surely important information that should be taken into account in public debate on illegal drug use. Discussions based on a formal assessment of harm rather than on prejudice and assumptions might help society to engage in a more rational debate about the relative risks and harms of drugs.

So that’s the conclusion of the world’s leading experts on this in the world’s leading medical journal.

QTR: Again, I emphasise that the score for tobacco and especially alcohol were heavily weighted by their numbers, especially in the area of social factors. This gave a falsely high impression of the dangers of these drugs. Should we make heroin legal, for instance, you could expect to see it’s score double as it wreaks massive harm in the community.

So that’s the conclusion of the world’s leading experts on this in the world’s leading medical journal.

These are experts in addiction, not experts in pharmacology or emergency medicine. They have, consequently, seriously underestimated the toxic properties and the social damage caused by most of these drugs. Anyone who puts alcohol above methamphetamine clearly doesn’t have a clue what he is talking about. Give me a drunk any day over a nutter whacked out on P.

PS The Lancet is only “the world’s leading medical journal” in it’s own mind. I would go for the BMJ or the NEJM

Quoth the Raven on March 4th, 2009 at 19:13

Mac – They have a category for amphetamines, but I don’t know whether they include methamphetamine in this or not. They make no mention of methamphetamine and have ecstasy in it’s own category, so I think it’s probably not in the study. If it is in the category other, relatively benign, amphetamines would have dragged the score down. There are many drugs not included in the study. There were participants from many different fields. For instance, the author I quoted above is a psychopharmacologist.
As to the toxicity of certain drugs, physical harm was part of their matrix so it was there. For instance, Cannabis has very low toxicity, there is no recorded overdoses in the thousands of years it has been used (how many a year do you get with alcohol?) the lethal dose of Cannabis is one third of a person’s bodyweight – so impossible to overdose. It’s the same for LSD there has been no overdose ever recorded. I know I’m not talking long term. Looking at this table under physical harm you can see that the scores for both acute and chronic are higher for alcohol than LSD and Cannabis. Again physical harm is something that isn’t going to change according to the number of users and social attitude towards a drug – it’s a product of its toxicity, method of use and psychological effects. Although, the data would be more accurate for drugs that are used extensively. OTOH as outlined above illegality can increase the physical harm. When they assessed toxicity they obviously looked at the results of other studies.

Not being an MD I think I’ll take words of the assorted experts who authored this article over you. How many journal articles have you authored? in what major journals? cited how many times? specifically about drugs?

ffs on March 4th, 2009 at 20:05

Blah blah blah – Yes let’s let the genie out of the bottle and legalise all drugs heck why not let people prescribe their own medications and do away with Drs all together, couldn’t possibly cause any additional harm.

QTR: Questioning my academic qualifications is pointless. I assuredly know how to read a scientific article and the holes in the one we are discussing are large enough to drive a bus through. This is NOT a scientific study, this is a group of self-appointed experts giving their opinion. There are no facts quoted, no studies cited.

You clearly understand no pharmacology. Metamphetamine is part of the class of drugs called amphetamines. It should therefore be included in the amphetamines.

Cannabis may not kill you except in massive overdosage, but there is clear evidence that it increases the likelihood of psychotic breakthroughs. There is also mediocre evidence that it may reduce motivation and exacerbate depression.

Quoth the Raven on March 4th, 2009 at 21:46

Mac – I read scientific journals all day. Look through the references in this article if your keen. It may well be that there is mediocre evidence that cannabis reduces motivation and exacerbates depression, I’m not arguing that; you will well know that there is ample evidence that alcohol can exacerbate depression. No, I don’t know much about pharmacology, I never said I did, nor did you ever say you did, being an MD does not make you an expert on pharmacology. I well know that medicine is as broad as any other scientific field and one should defer to those with speicalised knowledge in their respective fields. I don’t know if you know anything about academia, but you ought to know that people do not appoint themselves as experts. I think a quote from an MP in the UK is applicable here:“Things have gone from bad to worse, there is no possibility of an honest discussion now. Anyone who sticks their head above the parapet and calls for a rational consideration of the drug laws gets it shot off and kicked around by a horde of lunatics.”

ffs on March 5th, 2009 at 08:07

Good Lord it’s true. Lew really is the most pompous blowhard in the blogosphere

George Darroch on March 5th, 2009 at 15:44

Anyway, the substance of the article remains. Looking at the evidence, a logical person could only assume two things: National are involved in corruption, or they hate the people of New Zealand and have no concern for their health. I’m charitable, and like to think the best of people, so I’ll say the latter.